幽门螺杆菌感染知晓度调查：一项西安三甲医院的横断面研究

A Survey on the Awareness of Helicobacter pylori Infection: A Cross-Sectional Study in a Tertiary Hospital in Xi’an

摘要: 目的：对西安莲湖地区人口进行幽门螺杆菌(Helicobacter pylori, H. pylori)知识的掌握程度，以及对H. pylori筛查的态度进行问卷调查。方法：对2021年7月至2022年4月西安医学院第一附属医院消化内科门诊及住院患者进行问卷调查。调查表内容包括，一般信息如年龄、性别、居住地、文化程度及病史等，调查项目有H. pylori的感染性、H. pylori的危害性、H. pylori的传播途径(口–口传播、粪口–传播)和预防措施等。结果：1) 在调查的411例患者人群中，平均年龄50.37 ± 9.31岁，其中18~30岁的最少(16.55%)，大于50岁的人最多(29.68%)。男性45.99%，女性54.01%。初中及以下学历33.33%，高中/中专学历43.31%，大专及以上学历较少(24.57%)。大部分受访者居住在城镇(66.91%)。在疾病诊断方面，慢性胃炎占76.64%，消化性溃疡有23.36%。在饮食习惯方面，高达29.44%的人在给孩子喂食前咀嚼，只有9.27%人保持单独用餐的习惯。在H. pylori防治方面，44.04%的受访者听说过H. pylori。25.06%的人了解H. pylori的传播途径。在受访者中，19.22%的人接受过H. pylori检测，7.70%的人接受过H. pylori清除治疗，7.5%的人曾经被诊断为H. pylori感染。2) 对所有关于H. pylori感染性知识问题回答正确的受访人群人数66 (16.06%)人，对两个与H. pylori危害相关的单个选择问题给出了全部正确答案的人有126 (30.66%)人，对H. pylori预防措施了解的人有215 (52.31%)人。总的来说，我们的受访人群对H. pylori的了解程度较差。3) 不同年龄组、受教育程度、居住地等受访人群的H. pylori知识掌握程度有显著差异(P < 0.001)，性别不具有显著差异。各亚组中对H. pylori了解程度较低的人群比例也有显著的统计学差异(P < 0.001)，其中大于50岁的人群67 (54.92%)人，农村地区的人群85 (62.50%)人，初中及以下受教育程度的人群93 (67.88%)人。大多数不支持全国H. pylori筛查的人(69.28%)对H. pylori的知识掌握程度较低，而大多数接受H. pylori检测的人(83.87%)对H. pylori的知识掌握程度较高。结论：普通人群对H. pylori的了解相对较低，特别是18~30岁和≥ 50岁、生活在农村地区的人群，具有初中及以下文化程度。虽然民众对全国H. pylori筛查的支持率较高，但H. pylori的筛查率仍然很低，这可能是由于大家对H. pylori知识的掌握程度较低。因此，通过多种方式提高民众对H. pylori的认识以及增加对H. pylori防治的医疗投入，将有助于提高普通人群对H. pylori筛查及治疗积极性。

Abstract: Objective: To conduct a questionnaire survey on the knowledge of Helicobacter pylori (H. pylori) and the attitude toward H. pylori screening among the population in the Lianhu area of Xi’an. Methods: A questionnaire was administered to outpatients and inpatients of the Department of Gastroenterol-ogy of the First Affiliated Hospital of Xi’an Medical College from July 2021 to April 2022. The ques-tionnaire included general information such as age, sex, residence, education level and medical history, etc. The survey items included the infectivity of H. pylori, the hazard of H. pylori, the trans-mission route of H. pylori (oral-oral transmission, fecal-oral transmission) and preventive measures. Results: 1) In the population of 411 patients investigated, the average age was 50.37 ± 9.31 years, with the least number of 18~30 years old (16.55%) and the most number of people older than 50 years old (29.68%). 45.99% were male and 54.01% were female. 33.33% had junior high school education or below, 43.31% had high school/junior high school education, and fewer had college education or above (24.57%). Most of the respondents lived in towns (66.91%). In terms of disease diagnosis, chronic gastritis accounted for 76.64% and peptic ulcer had 23.36%. In terms of eating habits, up to 29.44% chewed before feeding their children, and only 9.27% kept the habit of eating alone. In terms of H. pylori control, 44.04% of the respondents had heard of H. pylori. 25.06% were aware of the transmission route of H. pylori. Of the respondents, 19.22% had been tested for H. py-lori, 7.70% had received H. pylori clearance treatment, and 7.5% had ever been diagnosed with H. pylori infection. 2) The number of respondents who answered correctly to all questions about knowledge of H. pylori infectivity was 66 (16.06%), and for the number of respondents who an-swered correctly to two individual choices related to H. pylori hazards, 126 (30.66%) gave all cor-rect answers to a single multiple-choice question related to H. pylori hazards, and 215 (52.31%) were knowledgeable about H. pylori preventive measures. Overall, our respondent population had poor knowledge of H. pylori. 3) There was a significant difference (P < 0.001) in the knowledge of H. pylori among different age groups, education level, and place of residence of the respondent popu-lation, with no significant difference by gender. There was also a statistically significant difference (P < 0.001) in the proportion of people with low knowledge of H. pylori in each subgroup, with 67 (54.92%) in people older than 50 years, 85 (62.50%) in people in rural areas, and 93 (67.88%) in people with junior high school education or less. The majority of people who did not support na-tional H. pylori screening (69.28%) had low knowledge of H. pylori, while the majority of people who were tested for H. pylori (83.87%) had high knowledge of H. pylori. Conclusions: Knowledge of H. py-lori is relatively low among the general population, especially among those aged 18~30 years and ≥50 years, living in rural areas, with lower secondary education and below. Although there was high public support for national H. pylori screening, the screening rate for H. pylori remained low, which may be due to the low level of knowledge about H. pylori. Therefore, raising awareness of H. pylori among the population and increasing medical investment in H. pylori prevention and treatment in multiple ways will help increase the general population’s motivation for H. pylori screening and treatment.